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Individual

DR. EVAN SHERECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3181 SW SAM JACKSON PARK RD,, MAIL CODE CDRC-P, PORTLAND, OR 97214
(503) 494-0829
(503) 494-0714
Mailing address
3181 SW SAM JACKSON PARK RD, MAIL CODE CDRC-P, PORTLAND, OR 97214
(503) 494-0829
(503) 494-0714

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD152990
OR
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
MD152990
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500628915
OR
Enumeration date
03/27/2007
Last updated
09/10/2012
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